The information collected on this form is submitted directly to your customer account. All of your information can be deleted immediately upon request. We never share, sell or give your information to anyone else. 
Full details of our Privacy Policy can be found online at https://www.threewisemonkeysclimbing.com/privacy-policy

Loading...

NOVICE SUPERVISION FORM

Supervised Use of 3 Wise Monkeys Climbing Centre - by a Registered Adult Unsupervised Climber

 


Review our Privacy Policy

This form must be completed by BOTH the Novice Climber and the Supervising Climber.

PARTICIPATION STATEMENT

“All climbing and bouldering activities have a risk of serious injury or death. Participants must be aware of and accept that even if they follow all good practice there may still be the risk of accident and injury. It is the responsibility of the participant to adhere to the conditions of use.”

It is important that you understand this document. There is inherent risk involved with climbing centres and associated activities. By signing this form, you are stating you understand that these risks cannot be completely removed. If you do not understand any of the terminology or content, ask a member of staff to clarify.

Supervised Climbing

  • An adult who has registered at the centre and proved competency, may supervise up to two novice climbers.
  • Supervisors must be prepared to take full responsibility for the safety of their novices, and must remain with them whilst in the centre.
  • Supervisors may only supervise within their declared competency.
  • The Supervisor has a duty to inform the novice of relevant risks and help them manage these risks.
  • Novices must not belay without on the ground supervision by their supervisor backing up the brake rope.
  • Particular care must be taken when supervising children in centres, as they are less aware of their surroundings.
  • If the novice is under the age of 18, a responsible adult must complete the form on their behalf.
  • If the supervisor of any under 18 is not the parent or legal guardian, then the supervisor must make the parent or legal guardian aware of the potential dangers involved with climbing, and must have received consent for the child to participate.

Groups of three or more novices must only be supervised by an instructor holding the relevant valid First Aid Certificate, Mountain Training qualification (or other relevant qualification) and insurance.

All children in the centre must be supervised by an adult unless they have been assessed by the management and registered for unsupervised climbing.

CONDITIONS OF USE

General Safety

- Report to reception on each visit before you climb.

- You must exercise care, common sense and self-preservation at all times.

- Report any problems with the walls, equipment or other climbers' behaviour to a member of staff immediately. This is particularly important with broken or spinning holds.

- Be aware of the other climbers around you and how your actions will affect them.

- Do not distract people while they are climbing or belaying.

- Never stand directly underneath someone who is climbing.

- If you have children, you must keep them under control and supervise them directly at all times. Be close enough to affect or control the child’s behaviour at all times.

- Please make yourself aware of the location of the fire exits in the building and fire assembly points.

As a user of this climbing wall, you must be aware of and accept the following:

- Volumes on the walls are designed to enhance the quality of climbing but you must be aware of and accept that when climbing above them there is an additional risk of falling onto them.

- Climbing beyond your capabilities on any wall is likely to result in a fall. Any fall may result in an injury despite the safety systems in place. You must make your own assessment of the risks whenever you climb.

- Participants must understand that climbing while pregnant can increase the risk posed to mother and unborn child.

- Participants must be aware and accept that climbing holds can spin or break

- You must do everything reasonable and practical to avoid endangering yourself or others.

- You have to be aware of and adhere to the safety rules of the centre at all times.

- Stand back from the climbing walls unless you are belaying or spotting a climber.

- You take responsibility for adequately maintaining your equipment.

- Please empty your pockets and remove all jewellery before climbing.

Top Rope Climbing

- Always use a climbing harness to attach yourself to the rope tying the rope directly into the harness using a figure of 8 knot with a stopper, or a bowline knot with a stopper. Clipping in with a carabiner is not advised.

- Many of the climbs in the centre have top ropes already in place. Do not take them down or move them.

- It is your responsibility to vet your climbing partner's ability before they belay you.

Lead Climbing

- Lead belaying requires a higher degree of skill and understanding from top rope belaying and should only be undertaken if you have received training or are competent to do so. If you are unsure do not climb and ask a staff member for available instruction at the centre.

- When using the lead walls, you must supply or rent (if available) your own appropriately rated dynamic rope.

- Quickdraws/runners/clips are provided on the lead wall. Please don’t use your own.

- You must not skip clips and clips must be clipped in order.

When Belaying

- Always abide by good practice when belaying.

- Always use a belay device attached to your climbing harness with a locking carabiner as per manufacturers' guidelines. ‘Traditional’, or ‘body’, belaying is not acceptable.

- To ensure your partner's safety, pay attention to what the climber is doing.

- Always stand as close to the climbing wall as is practical. Sitting or lying down is not acceptable.

Bouldering

- Whenever possible downclimb, or if this is not possible, use a controlled/planned jump.

- It is your responsibility to ensure that you can climb down or land safely; don’t climb into a situation that you cannot safely get out of.

- Never climb directly above or below another climber.

- Always take your harness off before bouldering.

- Top out (climb over the top) in designated areas only, if unsure climb down.

- Remove anything from pockets that could hurt you when landing.

- Always be aware of people climbing above and around you.

Training Area

- You use the training equipment at your own risk. If you are unsure how to safely use any item, please ask a member of staff.

Auto Belays

- If you are unsure in any way on how to use an auto belay, or have never used one before, then ask a member of staff for assistance before using one.

- The coloured box (usually yellow or red) on the ground around the auto belays is a landing zone; be aware of descending climbers when standing within it.

- Good practice instructions are located next/near to the auto belay. To ensure your own safety, please follow these instructions.


The bouldering wall is the site of most injuries at a climbing wall. THE SOFT MATTING DOES NOT REMOVE THE RISK OF INJURY. Injuries can still occur even after a controlled/planned jump but are more likely after an uncontrolled fall. You should always be doing your utmost to avoid the risk of uncontrolled falls. This includes paying attention to how you will land and always assessing the risk of each climb that you undertake.

Lead climbing also contains inherent risks, which are always present. Any leader fall can result in an injury and you must exercise great caution and preparation before you expose yourself to that risk.

In top roping and leading, the greatest risk is presented by the belayer. Always make sure they are skilled enough to keep you safe; if you are unsure consult a member of staff.

Our Duty of Care 

The conditions of use of the climbing centre are not intended to limit your enjoyment of the facilities; they are part of the duty of care that we, as operators, owe to you, the customer, by law. As such, they are not negotiable and if you are not prepared to abide by them then the staff may ask you to leave.

Your Duty of Care

You have a duty of care to act responsibly towards the other users of the centre, follow good practice and abide by the conditions of use of the centre. Statements of ‘Good Practice’ are posted around the centre adjacent to the relevant facilities. These describe the accepted methods of use of equipment and climbing areas.

Unsupervised Climbing

Before you can use the top ropes or lead walls without supervision the centre expects you to be competent in the use of a climbing harness, a suitable knot to attach a rope to the harness and a belay device to secure a falling climber or lower a climber from the wall using a rope.

Before you can use the bouldering walls without supervision, you must be aware of safe usage of bouldering and know how to use the bouldering walls safely.

You are required to register to say that you know how to top rope, lead or boulder, that you are prepared to abide by the conditions of use of the centre and that you understand the risks involved in your participation. Anyone who is not competent to climb unsupervised must be supervised by a competent person.

DECLARATIONS

I certify that to the best of my knowledge, I do not suffer from a medical condition that might have the effect of making it more likely that I be involved in an accident that could result in injury to myself or others.

I also confirm that the above information is correct and if any information changes I will notify the centre.

I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE DOCUMENT. I HAVE READ AND UNDERSTOOD IT, AND I AGREE TO BE BOUND BY ITS TERMS.


By signing here, as the Supervising Climber, I agree to and understand the above, and agree to be responsible for the safety and behaviour of the New Climber whilst using the climbing centre. 

Supervising Climber -

By signing here, as the Novice Climber, I agree to and understand the above, and agree for the Supervising Climber named on this form to be responsible for my safety whilst using the climbing centre. 

Novice Climber - 

April 26, 2024




First Adult Novice Climber Name

First Name*

Last Name*
First Adult Novice Climber Date of Birth*
First Adult Novice Climber Signature*
Second Adult Novice Climber Name

First Name*

Last Name*
Second Adult Novice Climber Date of Birth*
Third Adult Novice Climber Name

First Name*

Last Name*
Third Adult Novice Climber Date of Birth*
Fourth Adult Novice Climber Name

First Name*

Last Name*
Fourth Adult Novice Climber Date of Birth*
Fifth Adult Novice Climber Name

First Name*

Last Name*
Fifth Adult Novice Climber Date of Birth*
Sixth Adult Novice Climber Name

First Name*

Last Name*
Sixth Adult Novice Climber Date of Birth*
Seventh Adult Novice Climber Name

First Name*

Last Name*
Seventh Adult Novice Climber Date of Birth*
Eighth Adult Novice Climber Name

First Name*

Last Name*
Eighth Adult Novice Climber Date of Birth*
Ninth Adult Novice Climber Name

First Name*

Last Name*
Ninth Adult Novice Climber Date of Birth*
Tenth Adult Novice Climber Name

First Name*

Last Name*
Tenth Adult Novice Climber Date of Birth*

If you are an adult wishing to boulder in the centre separate to you supervisor you must first watch the bouldering induction video, fill out the Bouldering Adult Climber Registration Form and check in with a member of staff.


Responsible Adult Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Novice Climber Information

TO BE COMPLETED BY THE NOVICE CLIMBER OR THE RESPONSIBLE ADULT


Have you read and understood the participation statement at the top of this form and accept the risks involved with climbing?*
No
Yes
Do you agree for the supervising member named on this form to be responsible for your/their safety during your/their visit to this facility?*
No
Yes
Do you understand that you must NOT climb/boulder in the centre without your supervisor while signed in as a novice?*
No
Yes

Medical Notes
Supervising Climber

TO BE COMPLETED BY THE SUPERVISING CLIMBER


As the supervising person do you agree to be responsible for the safety and behaviour of your Novice during their visit?*
No
Yes
As the supervising person do you agree to draw your Novices attention to the conditions of use and to ensure that they adhere to these?*
No
Yes
If your Novice is under 18 years of age, have you made the parent or legal guardian aware of the risks involved in climbing, and have you received consent from them for their child to participate?*
No
Yes
N/A

For Roped Climbing Please also answer the following questions:

Are you able and willing to assist your Novice in the correct use of a climbing harness?*
No
Yes
Are you able and willing to assist your Novice in tying into their harness correctly using an appropriate climbing knot?*
No
Yes
Will you ensure that if your Novice belays you will back them up at all times by holding onto the brake end of the rope?*
No
Yes
IMPORTANT!

Once a form is completed, it cannot be edited. Please read through and carefully answer the following questions.

The responsible adult named on this form (as the Supervising Climber) must have obtained the parent(s) or court-appointed legal guardian(s) consent for any participating minor (those under 18 years of age), and they must have agreed that they and the minor are subject to all the terms of this document, as set forth above.




By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Responsible Adult Name

First Name*

Last Name*
Responsible Adult Date of Birth*
Responsible Adult Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE! and  Rock Gym Pro